Failure of Locoregional Anaesthesia in Dental Practice: Frequency, Causes and Replacement Strategies

Abstract

Background: Locoregional anaesthesia (LRA) is frequently practiced in odontostomatology. Our aim was to determine the frequency and causes of LRA failures and to evaluate replacement strategies in two peripheral hospitals in Cameroon. Methodology: A prospective and descriptive study was carried out in the department of odonto-stomatology of the Ebolowa Regional Hospital and Efoulan District hospital of Cameroon from the 1st of January to the 31st of August 31st 2022. Were included, patients presenting an oral pathology requiring LRA. The variables studied were: failure rate of LRA, the reasons of failure, the strategies used after failure and their efficiency. Data analysis was performed using Epi Info 3.5.4 software. The chi-square test was used, the p-value being considered significant if < 0.05. Results: The study sample consisted of 301 patients. The mean age was 29.9 ± 17.7 years and the sex ratio 1.3. The main pathologies were pulpopathies (47.8%). The most practiced nerve block was the truncal spina Spix anaesthesia (51.8%) with lidocaine and epinephrine. The failure rate of anaesthesia procedure was 73.4% due to the technique used. The strategies employed in case of failure were efficient in 81.4% of cases. Intra-pulpal and intra-septal anaesthesia were particularly mastered. Conclusion: Failures of LRA in odontostomatology in peripheral hospitals are very recurrent. It’s due to the lack of qualified experienced personnel. Strategies employed in the event of failure are efficient particularly intra-pulpal and intra-septal anaesthesia.